An Adaptive Intervention for Adolescents at Risk for Suicide: A Pilot SMART

University of Michigan

Status: Completed

Conditions: Self Harm; Suicide

Treatments: Behavioral: MI-Enhanced Safety Plan at Hospitalization (1st Component); Behavioral: MI-Enhanced Booster Call (3rd Component); Behavioral: MI-Enhanced Text Boosters (2nd Component)

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03838198

1K23MH113776-01 (U.S. NIH Grant/Contract)

HUM00129173

Details and patient eligibility

About

To inform the development of a technology-augmented adaptive intervention for adolescents at risk for suicide, the goal of this study is to conduct a Sequential, Multiple Assignment, Randomized Trial (SMART) pilot of a Motivational Interview (MI)-enhanced safety planning intervention (MI-SafeCope). Findings from this study will provide the groundwork for the construction of a technology-augmented adaptive intervention that could lead to a reduction in suicidal behaviors and related events during the high-risk post-discharge period-an important suicide prevention target.

Enrollment: 82 patients

Sex: All

Ages: 13 to 17 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Suicide attempt (previous month), and/or
• Suicidal ideation (previous week)

Exclusion criteria

• Severe cognitive impairment or altered mental status (psychosis, manic state)
• Transfer to medical unit or residential placement
• No availability of a legal guardian
• No cell phone with text messaging capability

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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82 participants in 4 patient groups

Safety plan + booster text messages + booster call (Group A)

Other group

Description:

Sequencing of MI-SafeCope intervention components (Phase 1 and Phase 2) resulting in Group A: Participants will receive the in-person MI-enhanced safety plan (individual meeting with the adolescent and a family meeting) during hospitalization -- focused on developing a personalized list of coping strategies and enhancing adolescents' motivation and self-efficacy to utilize these strategies-- which will be followed by 4 weeks of daily post-discharge booster text messages and a phone booster call.

Treatment:

Behavioral: MI-Enhanced Text Boosters (2nd Component)

Behavioral: MI-Enhanced Booster Call (3rd Component)

Behavioral: MI-Enhanced Safety Plan at Hospitalization (1st Component)

Safety plan + booster text messages (Group B)

Other group

Description:

Sequencing of MI-SafeCope intervention components (Phase 1 and Phase 2) resulting in Group B: Participants will receive the in-person MI-enhanced safety plan during hospitalization followed by 4 weeks of daily booster text messages post discharge.

Treatment:

Behavioral: MI-Enhanced Text Boosters (2nd Component)

Behavioral: MI-Enhanced Safety Plan at Hospitalization (1st Component)

Safety plan + booster call (Group C)

Other group

Description:

Sequencing of MI-SafeCope intervention components (Phase 1 and Phase 2) resulting in Group C: Participants will receive the in-person MI-enhanced safety plan during hospitalization followed by a post-discharge booster call.

Treatment:

Behavioral: MI-Enhanced Booster Call (3rd Component)

Behavioral: MI-Enhanced Safety Plan at Hospitalization (1st Component)

Safety plan (Group D)

Other group

Description:

Sequencing of MI-SafeCope intervention components (Phase 1 and Phase 2) resulting in Group D: Participants will receive the in-person MI-enhanced safety plan during hospitalization.

Treatment:

Behavioral: MI-Enhanced Safety Plan at Hospitalization (1st Component)